Clinical Imaging Out and About

A flood. The hospital is inundated. Demand for the computed tomograph is urgent, but the scanner is not working. Staff will have to find a way of reorganizing the entire clinical workflow. This is just one of the scenarios in which Alliance Medical and its wide range of mobile clinical devices could be of help.

Photos: Benjamin Rösner

Over a decade of expertiseAlliance Medical is a leading provider of imaging services in Europe with more than a decade of expertise in the mobile medical equipment sector. Trucks carrying its diagnostic devices are a permanent fixture on Europe’s roads. The company’s mobile fleet includes CT scanners, a mobile heart cath lab, PET/CT scanners, MRI scanners, X-ray systems, DEXA, mammography, and ESWL units. “Customers of Alliance include the NHS in the UK, private and public hospitals, as well as private imaging centers,” says Bastian Berkel, Sales Manager Europe at Alliance Medical Northern Europe. “We operate mobile units Europewide,” he adds.

Mobile imaging safeguardsFloods are not the only type of event that result in physicians having to seek out flexible solutions. For instance, a medical facility may have ordered a new, more advanced CT scanner to replace its previous model. To cover the time it takes to dismantle the old device, renovate the room, and install the new scanner, they can opt for a mobile solution. After all, if a diagnostic device like a CT scanner is out of action, staff have to reschedule appointments, send patients to other centers, and explain delays to referring physicians. Doctors cannot afford such heavy limitations on their workflows today, so a temporary solution makes good sense. Alliance Medical’s mobile devices remain on site for anything from a week to several years. “It depends entirely on the individual circumstances,” says Christopher Barfuß, Sales Manager at Alliance Medical. “For instance, one of our scanners has been at a facility in Ireland for several years now. They’re so happy with it that they don’t want it to go.” But this is an exception – devices are normally only deployed for a limited period of time. Some customers use them to bridge the gap until their new device is up and running. Others have more patients during certain periods than they can handle with their existing equipment. “In these cases, an extra, temporary device eases the bottleneck. Once the numbers drop again, things go back to normal,” says Barfuß.

Diverse challengesCurrent events in Europe have created an acute need for mobile X-ray scanners to screen the high numbers of refugees arriving from the Middle East and Africa. Screening every refugee for tuberculosis, for example, to safeguard public health is an immense challenge. Setting up mobile X-ray scanners close to refugee centers can offer a temporary solution. In this scenario, the diagnostic device comes to those who need it, rather than the other way around. This greatly eases the logistical burden for the on-site clinical staff who make these large-scale projects possible. Mobile solutions are also sometimes required for sporting events such as city marathons and transalpine races.

Alliance Medical is active in multiple European countries, which all differ widely in terms of the prevailing conditions and local healthcare systems. The company deals with this by offering flexible contract options. “In Italy and the UK, for instance, some hospitals and practices outsource all of their radiology services,” says Berkel. In those cases, a temporary solution is not just about the device and clinical staff – it also involves collaborating with labs and physicians to provide full the range of diagnostic tools.

The ideal CT: compact, flexible, and powerfulTo equip its latest mobile CT trailers, Alliance Medical chose to collaborate with Siemens. “SOMATOM Scope is the ideal scanner for our purposes,” says Barfuß. “As well as offering a mobile kit, which is essential for operating in trailers and containers, it also fits perfectly into our trailers.” This makes it easy to transport the scanners and avoids the need to drive at night with a police escort – which is the EU rule for transporting loads that are over 2.8 m wide.

Alliance Medical can therefore handle customer requirements on a very individual basis, and can set up temporary scanning solutions very quickly. “If permanent systems fail, we ideally aim to provide a mobile solution within two days,” says Berkel. If the medical facility knows where it wants the scanner and can provide a 125 A or 400 V high-voltage electricity connection (CEE) that is not more than 50 meters from the trailer, Alliance Medical can install the system within two hours. Hospitals using the mobile solution have been able to perform up to 30 patient scans per day.

Reliable cooperation and supportObviously, this requires a high level of acceptance and motivation on the part of clinical staff. Moving a scanner outside of the building means adapting workflows and sometimes getting used to a new system, as well. “We work with Siemens to provide staff with extensive training on the SOMATOM Scope scanner and the syngo user interface. The sessions are thorough and needs-based, so transitioning to the new system doesn’t take long,” says Barfuß. Once employees have adjusted to the somewhat snug interior of the trailer, the whole process runs smoothly – especially since the trailers can be extended sideways to provide more space around the device once they are at the location.

A major advantage for emergency patients is that the gurney can be wheeled directly out of the ambulance, onto the trailer platform, and then positioned next to the scanner table. This means there is no need to transfer trauma patients from the ambulance stretcher onto a transport stretcher. The service packages always include fast, on-site response if any problems arise. “We collaborate with Siemens service teams and react immediately if something stops working the way it is supposed to,” says Berkel.

Smooth return to clinical routine When the container or trailer is picked up at the end of the agreed period, the clinical staff are obviously glad to return to normal CT operations inside. However, the time spent working with the temporary scanner and its software can often actually ease the transition to the new CT scanner. “If a medical facility has already worked with the same software and a similar device in a temporary context, it makes it easier to get to grips with the new scanner,” says Barfuß. When Alliance Medical customers look back on their time with the interim mobile solution, most describe it as a really interesting experience. One radiology technical assistant said it was “a bit like clinical camping in style.”

To support hospitals in maintaining high standards even in challenging situations, Alliance Medical remains dedicated to providing customers with flexible tailored solutions and to getting mobile medical devices out and about.

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The statements by Siemens’ customers described herein are based on results that were achieved in the customer's unique setting. Since there is no "typical" hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption) there can be no guarantee that other customers will achieve the same results.